'It changed who I felt I was.' Women tell of devastation at early menopause diagnosis

For Mary*, being told she’d entered menopause much earlier than expected was a shock …

It was sort of like I’d gone from 39 […] instead of turning 40, I’d almost turned 80. So I’d sort of skipped 40 years.

Around 10% of women – including many who believe they have the prospect having children ahead of them – are suddenly told they are at the end of their fertile life, and at greater risk of diseases normally associated with middle age.

In the course of our work with women and research, hundreds of women have shared their experiences of early menopause. They provide insights into how the physical changes have affected their sense of self and their relationships.

Read more: Making sense of menopausal hormone therapy means understanding the benefits as well as the risks

What is early menopause?

Menopause refers to the time in a woman’s life when the ovaries stop producing eggs, periods stop, and oestrogen levels dramatically drop.

The usual age of menopause, defined as 12 months without periods, is around 51 years. Early menopause occurs before 45 years. Premature menopause or premature ovarian insufficiency (POI), occurs before age 40.

Early menopause can happen without warning and the causes may never be known; although a family history of POI, autoimmune disease, smoking, early development and social factors are risk factors. It can also result from medical care such as chemotherapy, radiotherapy or the surgical removal of both ovaries. Except for women who have their ovaries removed, predicting who will experience early menopause is very difficult.

Hot flushes, night sweats and the rest

The symptoms of early menopause can be similar to those associated with usual menopause (hot flushes, night sweats, mood changes, vaginal dryness, sleep disturbance, sexual problems, fatigue, joint pain, and brain fade), but happen to much younger women and may be more severe. The problem is that no one expects young women to be experiencing menopausal symptoms.

Some women may not have any menopausal symptoms and only experience their periods stopping without warning. Others discover they are unable to become pregnant. Sonia* remembers:

Around 35, 36 I started to skip periods […] I just thought it was stress and overwork, and that sort of thing. But then the gaps between periods got longer and longer, and I started to experience night sweats. And I became concerned at that point, not because I thought that I was going through menopause – it didn’t occur to me.

Although we think of oestrogen as a reproductive hormone, it also plays an important role in brain function, particularly memory. Women who experience early menopause often report frustration at not mentally performing in the way they used to, and also find mood changes difficult to cope with. The cause of early menopause (such as chemotherapy) and the symptoms experienced (like sleep disturbance) can also impact thinking and mood.

Read more: 'Brain fog' during menopause is real – it can disrupt women's work and spark dementia fears

Feeling less than sexy

Early menopause can affect sexual function in many ways. Vaginal dryness can cause pain with sexual intercourse. Women often say they lose desire for sex, which can strain intimate relationships.

Cathy told us she wanted to be left alone:

It changed who I felt I was […] It’s hard to be sexy when you’re cranky […] To think of yourself as a sexual being [is difficult] when you are experiencing hot flushes every hour and you’re going, ‘I don’t want anyone near me. All I want to do is feel cool.‘